title: Value of oral glucose tolerance test in the acute phase of myocardial infarction.
abstract: BACKGROUND
  Although European guidelines advise oral glucose tolerance test (OGTT) in patients with acute myocardial infarction (AMI) before or shortly after hospital discharge, data supporting this recommendation are inconclusive. We aimed to analyze whether disturbances in glucose metabolism diagnosed before hospital discharge in AMI patients represents a latent pre-existing condition or rather temporary finding. Additionally, we planned to investigate the value of pre-selected glycemic control parameters as predictors of long-term glucometabolic state.
  
  
  METHODS
  We assessed admission glycemia, glycated hemoglobin, mean blood glucose concentration on days 1 and 2 in 200 patients with a first AMI but without overt disturbances of glucose metabolism. We also performed OGTT at discharge and 3 months after discharge.
  
  
  RESULTS
  The prevalence of disturbances in glucose metabolism (as assessed by OGTT) at 3 months was significantly lower than at discharge (29% vs. 48%, p = 0.0001). Disturbances in glucose metabolism were not confirmed in 63% of patients with impaired glucose tolerance and in 36% of patients with diabetes mellitus diagnosed during the acute phase of AMI. Age >77 years, glucose ≥ 12.06 mmol/l at 120 minutes during OGTT before discharge and mean blood glucose level on day 2 >7.5 mmol/l were identified as independent predictors of disturbances in glucose metabolism at the 3-month follow-up.
  
  
  CONCLUSIONS
  Disturbances in glucose metabolism observed in patients with a first AMI are predominantly transient. Elderly age, high plasma glucose concentration at 120 minutes during OGTT at discharge and elevated mean blood glucose level on day 2 were associated with sustained disturbances in glucose metabolism.
authors.affiliation: Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Bronisz
authors.forename: Marek
authors.initials: M
authors.lastname: Kozinski
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Magielski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Fabiszak
authors.forename: Joanna
authors.initials: J
authors.lastname: Gierach
authors.forename: Iwona
authors.initials: I
authors.lastname: Swiatkiewicz
authors.forename: Adam
authors.initials: A
authors.lastname: Sukiennik
authors.forename: Aldona
authors.initials: A
authors.lastname: Kubica
authors.forename: Marek
authors.initials: M
authors.lastname: Bronisz
authors.forename: Zofia
authors.initials: Z
authors.lastname: Grabczewska
authors.forename: Anna
authors.initials: A
authors.lastname: Sinkiewicz
authors.forename: Roman
authors.initials: R
authors.lastname: Junik
authors.forename: Jacek
authors.initials: J
authors.lastname: Kubica
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D016009:Chi-Square Distribution; D016002:Discriminant Analysis; D005260:Female; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D010343:Patient Admission; D010351:Patient Discharge; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human